Abstract
The development and organisation of traffic accident emergency services in the USA is described. An increase in the survival rate of the severely injured from 38% to 84% is claimed by individual units such as the Maryland Institute of Emergency Medicine. Details are given of emergency medical technician training given to ambulance men before further training is given to become a paramedic. It is suggested by the author that emergency medical services in the UK have not progressed for reasons discussed and that much could be learnt from the American system.